Readily Identifiable Risk Factors of Nursing Home Residents’ Oral Hygiene: Dementia, Hospice, and Length of Stay

• Published in: Journal of the American Geriatrics Society (JAGS) 2017-11, Vol.65 (11), p.2516-2521
• Main Authors: Zimmerman, Sheryl, Austin, Sophie, Cohen, Lauren, Reed, David, Poole, Patricia, Ward, Kimberly, Sloane, Philip D.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Chronic Periodontitis - epidemiology; Chronic Periodontitis - nursing; Cross-Sectional Studies; Dementia; Dementia - epidemiology; Dementia - nursing; Dementia disorders; Dentures; Female; Geriatric Assessment; Gingival index; Gingivitis; Hospice care; Hospice Care - statistics & numerical data; Humans; Length of Stay - statistics & numerical data; Long term health care; long‐term care; Male; Minimum Data Set; mouth care; North Carolina; Nursing Homes; Oral Health - statistics & numerical data; Oral hygiene; Oral Hygiene - statistics & numerical data; Plaque index; Quality control; Risk Factors
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.15061

Background/Objectives The poor oral hygiene of nursing home (NH) residents is a matter of increasing concern, especially because of its relationship with pneumonia and other health events. Because details and related risk factors in this area are scant and providers need to be able to easily identify those residents at most risk, this study comprehensively examined the plaque, gingival, and denture status of NH residents, as well as readily available correlates of those indicators of oral hygiene, including items from the Minimum Data Set (MDS). Design Oral hygiene assessment and chart conducted on a cross‐section of NH residents. Setting NHs in North Carolina (N = 14). Participants NH residents (N = 506). Measurements Descriptive data from the MDS and assessments using three standardized measures: the Plaque Index for Long‐Term Care (PI‐LTC), the Gingival Index for Long‐Term Care (GI‐LTC), and the Denture Plaque Index (DPI). Results Oral hygiene scores averaged 1.7 (of 3) for the PI‐LTC, 1.5 (of 4) for the GI‐LTC, and 2.2 (of 4) for the DPI. Factors most strongly associated with poor oral hygiene scores included having dementia, being on hospice care, and longer stay. MDS ratings of gingivitis differed significantly from oral hygiene assessments. Conclusions The findings identify resident subgroups at especially high risk of poor oral health who can be targeted in quality improvement efforts related to oral hygiene; they also indicate need to improve the accuracy of how MDS items are completed.